Pediatric Occupational Therapists: Help with refusal of spoon to mouth

DEAR ERI COMMUNITY: I am a pediatric occupational therapist. I have several kiddos on my caseload now who are all on the spectrum. Each one resists taking a spoon to mouth and has a limited acceptance of a variety of foods. Even when a preferred food is placed on the utensil they refuse to eat from the spoon. They will pick the food off the spoon and eat it but will refuse if it is presented on the utensil. Any suggestions on where to start and treatment ideas?

7 Responses to Pediatric Occupational Therapists: Help with refusal of spoon to mouth

The first thing that pops into my head, is having them (no matter what age)use the Lil Dipper and just show them how they can dip and then taste (or if not ready for taste, paint it on their hands, arms, slowly working to mouth). You can show them how to ‘lick’ it from the Lil Dipper like a lollipop or ice cream and have some fun with it! You also may want to consider putting the spoon away for a while, while you do this. I hope this helps in any way!

They may not like the metal of the utensils. Have you tried plastic? If they have a learned aversion and refuse all utensil use, then try some fun things that may seem silly to them, like eating off a large wooden spoon,using chop sticks or tongs. If they drink from a cup they could self-feed from a nosey cup. However,even if one of these ideas work, continue to try and work toward using utensils. I would also have them play with utensils without the stress of feeding by feeding dolls, stirring paint, scooping bubbles, etc with lots of praise and reward for using a utensil. Hope that helps.

One idea that I’ve had success with is to use an item that they play with already and have no problem bringing to their mouth, dip it in something that they like the flavor of and use it as a spoon (so they get used to the idea of using an item as a utensil) and in addition, let them acclimate to the spoon that you want to use by playing with it empty, feeding toys with it, playing with it in the bathtub, etc. Then slowly transition to accepting touch with it, touching their hands, then arms with the spoon and working up to the face and finally the mouth, tasting the spoon wet and dry, finding whatever is not threatening and works for them. I always do these activities after preparing their system with “heavy work” activities so that they are more organized and can handle stimulation more easily, watching for cues that they’ve had enough. Hope this helps, good luck!

I would try different spoons. Coated, plastic, maroon, flat,deep. Play games with spoons. Hang spoon on your nose, put spoons on table with food on them and then eat from spoon like puppy in front of child. If child is on spectrum, try the same games each session and do lots of modeling at how much fun it is.